Hello. I am considering NP and PA school. I have a few years of experience as an ED Tech in a Level 3 Trauma Center in California (busy, but not too intense). Our ED is staffed with PA's no NP's.
I have a few questions about clinical differences between NP's and PA's. I know that PA's seem to have a great ability to work in surgery specialties like ortho, neuro, peds, and cardio surgery. They do pre and post surgery exams, order interprets tests, and prescribe meds (at least in 47-49 states). Are there any NP's on this forum who do this? Are there any in California who can comment?
Second. I know that most PA schools have a much longer clinical component than do NP schools. I have been told it is because NP's already have so much clinical experience as nurses. But can you really compare the two? In our ED, the nurses are not making differential diagnoses, determining etiology of disease, etc. etc., they are monitoring the pt's overall state and response to the treatment ordered by the Physician (or sometimes PA). Therefore, does this experience compare to the rigorous training PA's get in diagnosing?
Part of my interest in medicine is the actual procedures themselves. I want to do chest tubes, central lines, suturing, first assistant surgery, etc. etc. Are there any NP's out there who are doing this?
Finally, I know some people (including some nurses) who deride the "nursing diagnosis" concept. Can anyone offer up a brief rationale for how nursing diagnoses are of value to an NP in clinical practice?
Wow! Lots of thoughts about advanced practice. I am glad to be in advanced practice nursing, but if there had been a choice of a PA school closeby, I would have done that instead. I liked the fact that the PA programs offer more clinical training and less topics in research and Nursing history! I work alongside MDs DOs PAs and NPs in an ER setting. I do think my ER nurse background has as much to do with my success in practice than any specific thing I learned in NP school.
Did your NP program lack pharmacology, pathophys, health promotion, ethics, managment, clinical courses?
I wonder if some forget that in probably most masters programs you have to write papers, do thesis or projects, etc., and that it is not just clinical training.
again, lots of misinformation about PAs. I'll try to address a couple.
Even though PA education is offered at varying DEGREES, the compentcies are THE SAME. Even the certificate and associates degree PA programs require extensive prerequisite work. Even though they may leave with no degree at all, they like have as many credit hours and as much college education as most NPs.
BSNs do not have 3 years of clinical time. In fact, the BSN programs in my home town have 2 years of pre reqs and 2 years of 1/2 class and 1/2 clinicals. which = 1 year of clincals. Another BSN program is the first 2 years as a ADN program and 2nd 2 years are random "BSN" classes. I have taken a few of the BSN classes, they are ridiculously easy and pointless. Nothing more than a money machine that prints out a piece of paper that says BSN after it eats 20k of your dollars.
Also, there are plenty of RNs out there who got their RN/BSN in a 1 year accelerated program after getting their psych degree.
again, lots of misinformation about pas. i'll try to address a couple.
even though they may leave with no degree at all, they like have as many credit hours and as much college education as most nps.
they leave with no degree and have as much college education as "most" nps? i am guessing "most" nps have 120 credits for bs and another 50-60 of graduate credits. so explain to me why would a pa program have 170 to 180 credits and offer "no degree" ? are you trolling?
bsns do not have 3 years of clinical time. in fact, the bsn programs in my home town have 2 years of pre reqs and 2 years of 1/2 class and 1/2 clinicals. which = 1 year of clincals. another bsn program is the first 2 years as a adn program and 2nd 2 years are random "bsn" classes. i have taken a few of the bsn classes, they are ridiculously easy and pointless. nothing more than a money machine that prints out a piece of paper that says bsn after it eats 20k of your dollars.
are you in your hometown bsn program? if not how would you be able to take these ridiculously easy and pointless courses?
also, there are plenty of rns out there who got their rn/bsn in a 1 year accelerated program after getting their psych degree.
how plenty? are these 12 month programs also ridiculously easy and have pointless courses?
you started discussing misinformation about pas, yet the majority of your post is about bsn education being worthless. i am not sure of understanding of nursing other than you have a significant level of disdain for the nursing role.
in the general consensus, physician assistants hold a masters of science in physician assistant studies. however, for this profession, educational requirements are inconsistent and sometimes inadequate. there really is no general requirement. today, for degrees in physician assistant studies, programs at the associates, baccalaureate and graduate levels exist, as well as certificate of completion programs.
i think that you have a poor understanding of pa education. pa education is based on clinical competency. i would challenge you to show me where the educational requirements are inconsistent or inadequate.
the design of pa education is a continuous feedback loop. the accrediting commission looks at what pa's in practice are doing, defines these actions as clinical competencies and then applies these competencies to the education model. the core curriculum is the same for every pa. this is something that cannot be said for most other fields. after that programs are free to add additional competencies, but every pa must meet the minimum. while these competencies are all conducted at the graduate level, some programs for a variety of reasons, may choose to give another degree. once again the degree does not define the pa, the education and training in clinical medicine does.
nurse practitioners, on the other hand, are required to possess a minimum of a masters degree in, i believe, all 51 states. the program, while indeed rigorous and challenging, is not medical school.
np's practice advanced practice nursing. i am not sure if all states currently require a master's although medicare certainly does to bill. however, there are plenty of np's out there that do not have master's or even bachelor's. that does not make them poor np's. they are quite competent and excellent clinicians.
pa's are required much of the same educational curriculum as physicians, but it's generally not as in-depth nor does the material encompass the same information. as far as licensure goes, physician assistants are required to pass national certification for initial licensure and then again every two years to maintain their license, i believe. pa's hold their own license to practice medicine, however practice is required to be under the supervision of a licensed physician with a collaborative agreement in place. this agreement varies from state-to-state depending on that particular state's board of medicine and their statutes.
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best regards
pa's do not have the same curriculum as physicians. pa education is very focused on producing a practicing clinician. the physician training is heavier on basic sciences with the intention of producing a medical practitioner who then aquires clinical skills during their residency and fellowship.
pa's are required to certify initially. to maintain certification pa's must submit 100 cme's every two years and take the recertification exam every six years.
pa's practice medicine, but must have a supervision agreement with a physician. the scope of practice is limited by physicians scope of practice and the limitations imposed by the the physician.
other professions seem to want to define pa's by the lack or possession of the degree. the degree is irrelevant to practicing as a pa. what defines the pa is broad based medical education and clinical competency. ultimately what defines the pa is putting pa-c after your name.
We have more experience than PA's. We have a different style of approach in terms of being more likely to look at lifestyle and nutrition in addition to disease and medications. We are great at prevention but can also function as specialists too (I hold wound specialist and family practice certifications).
Now, that said, have I met some fine PA's? Yes! Have there been some ARNP's less clued in? A few. That is true of MD's too. If you want to do school fast and be supervised and learn under a medical model, o.k. If you want more of a wholistic medical model focus but a longer course of study and experience, then be an ARNP. Wherever you go, the program, the mentors, and what you put into it is what counts. But think about this, how would you feel if you knew your MD "rushed" through med school?
Best of luck. kimmercris MSN, ARNP, WOCN edmonds, WA
I am a RN and currently in my clinical year of PA school. In my program there are many different disiplines of healthcare with years of experience. It has been a pleasure to learn alongside Chiros, PT, OT, Resptechs, RDs, foriegn MDs, acupuncture/chinese med, surgical techs, mental health and PHDs.
To say PA school rushes you through is true. It is fast, intense and requires dedication. In my clinical year i spend 40/hr per week min. in clinc/rotations plus getting ready for my daily "PIMP"ing by my MD preceptors.
My counterpart NP students in clinic spend 3 hours 3days a week in clinic while attending online courses and working fulltime. So I do see why the course of study takes longer!
The only question I have is why it is called "advanced nursing" when it truth it is practicing Medicine?
how plenty? are these 12 month programs also ridiculously easy and have pointless courses?
my sister in law completed one, and it was very difficult. why the attitude? my comment on bsn education has nothing to with the accelerated rn programs. it had to do with my personal experience and the need to clarify that bsn education in my hometown is very unlike the bsn education described by a previous poster.
"they leave with no degree and have as much college education as "most" nps? i am guessing "most" nps have 120 credits for bs and another 50-60 of graduate credits. so explain to me why would a pa program have 170 to 180 credits and offer "no degree" ? are you trolling? "
that is correct. please research the admission's requirements for programs that only award certificates or associates degrees. they all require at least 2 years of pre requisite work and the professional phase of a pa program usually involves a significant ammount of academic credit. they offer no degree because pa education is competency based. well, it used to be, but now so many people are getting so stuck on "degrees" that its embarassing. all of the while the only people gaining anything off of the squables about how important it is to have a masters (or even now a doctorate) are the new private investors of sallie mae and student finance department heads in your college (columbia started the first dnp didnt it? interesting) recieving kick backs. degree requirements only hurt us and our patients.. competency requirements are all we need!
are you in your hometown bsn program? if not how would you be able to take these ridiculously easy and pointless courses?
no, i am not in the bsn program, i have taken the classes as part of a bachelor's requirement. they serve a purpose, to get the bachelor's degree so you can get into pa school.
i am sorry i struck you the wrong way, i was not attacking anyone in particular nor bsns as a whole. that is why i made it a point to clarify that this was my personal experience.
Specializes in Policy, Emergency OR, Peds OR, CVOR.
I thought I knew which path I was on........ until I read all 400 (at least!):) pages of this. Now I am truly confused.
I have spent time on student doctor, pa, and nursing forums and the bickering is insane. It is quite embarrassing. I was under the impression that we are all adults.
I live in NC, a very PA friendly state, and respect PAs enormously (My family's PCP is a PA). I am in nursing school and admire NPs tremendously. I just don't quite know which side of the battle to join. The 10 or so posts that actually answered to OP's question were quite informative and have brought up questions I need to ask myself.
The decision any one person makes, NP or PA, is completely their own and shouldn't be tainted by mudslinging from either side.
To all of you that have tempered this discussion with your wisdom, I thank you on behalf of all of us out here yet to decide on the fork in our road.
what exactly is the difference between the "medical" model and the "nursing" model? From what I see, yes PAs and NPs apply for the same jobs so the difference in models dont seem to matter as much as the practitioner itself...perhaps its just a name people focus too much on.
what exactly is the difference between the "medical" model and the "nursing" model? from what i see, yes pas and nps apply for the same jobs so the difference in models dont seem to matter as much as the practitioner itself...perhaps its just a name people focus too much on.
great point, the person makes the role. the education can make the role even more successful. i prefer the "patient" model, i take what i like from both medcial and nursing and apply to my practice. the things i don't like about either one i don't use. health promotion activities is one of the things that nursing does very well, pender's model is pragmatic and effective. nothing complicated, places health promotion into a framework that can be evaluated and measured.
prairienp
315 Posts
Did your NP program lack pharmacology, pathophys, health promotion, ethics, managment, clinical courses?